05. Injection Protocols

Anabolic/androgenic steroid injections are always given deep in the muscle (intramuscular). Some other performance-enhancing drugs such as human growth hormone and insulin injections are given by injection in the fat layer between the skin and muscle (subcutaneous). The protocols for both injection types are provided. Improper injection technique can result in health complications such as inflammation, bacterial abscess or other infection, scar tissue development, septic shock, or other tissue or nerve injury. Furthermore, the sharing of needles or vials may result in the transmission of blood-borne pathogens including HIV and hepatitis. It is important to closely follow accepted sterility and safety practices for every injection, including the proper disposal of all equipment immediately after use.

General Preparation

1. Make sure you have all the necessary supplies.

Intramuscular Injection

(1) 3mL syringe
(1) 22-25g 1-1.5” needle for administering the injection
(1) 21g 1-1.5” needle for drawing solution (if using a multi-dose vial)
(2) Alcohol pads
(1) Dry cotton ball
(1) Plastic bandage

Intramuscular
Syringe with needle attached.

Subcutaneous Injection

(1) Insulin syringe with needle attached (.5-1mL 27-30g)
(2) Alcohol pads (1) Dry cotton ball
(1) Plastic bandage

Subcutaneous injection
Syringe with needle

2. If applicable, keep the administration needle cold by leaving it in the freezer for at least one hour before opening. This will help dull the pinch of penetration.

3. Select a well-lit room with a clean hard surface such as a tabletop or counter to administer the injection.

4. Wash hands thoroughly with soap and warm water.

5. Assure that all injection equipment is sealed and unused. Never reuse needles. Double check the expiration dates on all edications.

6. Clean top of vial thoroughly with an alcohol pad, if applicable. Let air dry for 15 seconds.

Precautions: Do not use injection equipment that is used or has been exposed to air during storage. Never share needles or multi-dose vials. Discard unused portions of the drug at the recommended time.

Drawing Solution into Syringe

1. Remove syringe from packaging. Attach drawing needle, if applicable.

2. If using a multi-dose vial, fill syringe with air in the amount you are withdrawing. This will help stabilize the pressure and make drawing easier.

3. If using an ampule, break open and place flat on a hard surface. The use of a paper towel to cover the glass top may make breaking easier. Draw solution. Skip below steps and go to Intramuscular or Subcutaneous Injection Procedure.

4. If using a vial, insert needle through the rubber stopper at a 90-degree angle. Turn the vial upside down with needle attached. Inject air. Slowly withdraw desired amount of solution. You may lightly tap the side of the needle to dislodge air bubbles. Note that small air bubbles are not harmful.

5. Remove needle and syringe from vial, if applicable. Replace cap on the end of needle.

Keep fingers away from needle when drawing.

6. Remove drawing needle and replace with new administration needle, if applicable. This is highly advised with multi-dose vials, as passage through the rubber stopper will have dulled the needle considerably. Remove any air in the tip of the needle, and prepare for injection.

7. Place capped needle back inside wrapper and place on clean surface.

Precautions: Never touch the tip of the exposed syringe, the needle, or the top of the vial stopper after it has been cleaned with alcohol. If you come into contact with these surfaces you should consider the materials contaminated, and should not use them for injection.

Intramuscular Injection Procedure

Used for all anabolic/androgenic steroid injections.

1. Thoroughly clean the intended site of injection with second alcohol pad. Preferred locations are the upper outer quadrant of the buttocks, or the outer side of the thigh. Let air dry for 15 seconds.

2. Remove needle cap. With free hand, stretch the skin around the site of injection with two fingers. Move the skin over the muscle to the side by 1-1.5” (Z-Track method).

3. In a swift motion, insert the needle into the target muscle at a 90-degree angle with the dominant hand. Make sure the needle is deep within the muscle.

4. Pull back on the plunger (aspirate). If the syringe fills with blood you have hit a blood vessel, and the injection should be aborted.

5. Inject the medication slowly into the muscle.

Upper/Outer buttocks is the preferred site for IM injection.
The outer side of the leg is also commonly used.

6. Withdraw the syringe. Release the skin with your other hand. The skin and subcutaneous tissue will rebound, which helps close off the needle shaft and prevent leaking.

7. Dry injection site with dry cotton ball. Cover with plastic bandage if necessary.

Precautions: Never inject into skin that is discolored, broken, or irritated, or if there are lumps, knots, or feelings of pain in the area. Do not inject more than 3mL at one time. Rotate the site of injection so that you do not inject in the same muscle more than once every two weeks.

Subcutaneous Injection Procedure

1. Thoroughly clean the intended site of injection with second alcohol pad. The preferred location is the lower abdominal region. Let air dry for 15 seconds.

2. Remove needle cap. With free hand, pinch the skin around the site of injection so it is lifted off the muscle.

3. In a swift motion, insert the needle into the target area at a 45-degree angle with dominant hand. Make sure the needle rests within the subcutaneous tissues between the skin and muscle.

4. Inject the medication slowly into the subcutaneous tissue. Do not aspirate.

5. Withdraw the syringe. Release the skin with your other hand.

The skin is pinched upwards to facilitate injection into the subcutaneous tissues.

6. Dry injection site with dry cotton ball. Cover with plastic bandage if necessary.

Precautions: Never inject into skin that is discolored, broken, or irritated, or if there are lumps, knots, or feelings of pain in the area. Do not inject more than 1mL at one time. Rotate the site of injection each time so that you are at least 1” away from the last site, and do not return to a previous site until all other available sites have been used. This will help prevent overuse of the same injection area.

References

Wlliam Llewellyn (2011) - Anabolics

Back to Steroids administration

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